目的 探讨注射用利福霉素钠联合注射用美罗培南治疗小儿化脓性脑膜炎疗效。方法 回顾性分析2020年3月—2021年3月在南阳市中心医院治疗的96例化脓性脑膜炎患儿临床资料，根据用药的差别分为对照组和治疗组，每组各48例。对照组静脉滴注注射用美罗培南，每次20 mg/kg同生理盐水100 mL配伍，每8 h 1次；治疗组在对照组基础上静脉滴注注射用利福霉素钠，每次15 mg/kg同生理盐水100 mL配伍，12 h 1次每。两组均经10 d治疗。观察两组患儿临床疗效，比较治疗前后两组患儿临床症状改善时间，及血清乳酸（LACT）、降钙素原（PCT）、硫化氢（H₂S）和一氧化氮（NO）水平。结果 经治疗，治疗组总有效率显著高于对照组（97.92%vs 83.33%，P<0.05）。经治疗，治疗组临床症状改善时间明显早于对照组（P<0.05）。经治疗，两组患者血清LACT、PCT、H₂S和NO水平明显降低（P<0.05），且以治疗组下降最显著（P<0.05）。结论 注射用利福霉素钠联合注射用美罗培南治疗小儿化脓性脑膜炎可有效改善患儿临床症状，具有一定的临床推广应用价值。

Objective To investigate the curative effect of rifamycin combined with meropenem in treatment of children with purulent meningitis. Methods The clinical data of 96 children with purulent meningitis treated in Nanyang Central Hospital from March 2020 to March 2021 were analyzed retrospectively, and divided into control and treatment groups according to the difference of medication, and each group had 48 cases. Children in the control group were iv administered with Meropenem for injection, 20 mg/kg added into normal saline 100 mL, once every 8 h. Children in the treatment group were iv administered with Rifamycin Sodium for injection, 15 mg/kg added into normal saline 100 mL, once every 12 h. Children in two groups were treated for 10 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the levels of serum cytokine LACT, PCT, H₂S, and NO in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.92% vs 83.33%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the serum levels of LACT, PCT, H₂S, and NO in two groups were significantly decreased (P< 0.05), especially in the treatment group (P < 0.05). Conclusion Rifamycin combined with meropenem in treatment of children with purulent meningitis can effectively improve the clinical symptoms, which has a certain clinical application value. on the basis of the control group.

R985

河南省医学科技攻关计划联合共建项目（LHGJ20191453）